Publishing cardiac surgery mortality rates: lessons for other specialties

The National Health Service Commissioning Board recently announced that mortality rates and other outcomes of surgery will be published for 10 specialties by summer 2013.1 This comes 12 years after the public inquiry into paediatric cardiac surgery at Bristol Royal Infirmary recommended that results by clinical team should be published to drive quality and prevent failures of clinical governance.2 UK cardiac surgeons were working towards this when the Freedom of Information Act was introduced in 2005. This led to a request from the Guardian newspaper for surgeons’ outcomes from all hospitals, which were published in April 2005.3 The Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) has published mortality rates for all NHS hospitals and about 80% of surgeons since then.4 5 This programme has been associated with clear improvements in risk adjusted mortality without obvious adverse consequences.6

The 10 specialties named by the Commissioning Board all have national registries supported by public money through the Healthcare Quality Improvement Partnership. Going from a clinical registry to healthcare provider reports sounds simple, but in practice there are several challenges to overcome. Here we report our experiences in adult cardiac surgery to help inform this process.